生物可吸收张力带治疗尺骨鹰嘴骨折

作者采用Ｂｉｏｆｉｘ可吸收固定棒代克氏针和Ｂｉｏｐｏｌｙ人工韧带代钢丝形成可吸收张力带治疗尺骨鹰嘴骨折共１８例，全部获随访，平均随访时间７．５个月，疗效判定以局部功能恢复情况和术后影像学综合判断。结果：优１６例，良２例，差零例，术后未出现骨折或骨折再移位现象，无伤口感染。作者认为生物可吸收张力带具有无需二期手术，减少病人痛苦，简单方便，又不增加费用等优点，是治疗尺骨鹰嘴骨折较理想的方法。     

尺骨鹰嘴接骨板与张力带钢丝内固定治疗尺骨鹰嘴骨折疗效观察

目的 比较尺骨鹰嘴接骨板与克氏针张力带钢丝内固定治疗尺骨鹰嘴骨折的临床疗效.方法回顾性研究尺骨鹰嘴骨折50例,分为接骨板治疗组(16例)和张力带钢丝治疗组(34例).结果获得随访8～16个月,平均12个月.疗效随访结果为:钢板组优14例,良1例,可1例;张力带组优30例,良2例,可2例.结论尺骨鹰嘴接骨板和张力带钢丝都...     

生物可吸收张力带治疗尺骨鹰嘴骨折

作者采用Biofix可吸收固定棒代克氏针和Biopoly人工韧带代钢丝形成可吸收张力带治疗尺骨鹰嘴骨折共18例,全部获随访,平均随访时间7.5个月,疗效判定以局部功能恢复情况和术后影像学综合判断。结果;优16例,良2例,差零例,术后未出现骨折或骨折再移位现象,无伤口感染。作者认为生物可吸收张力带具有无需二期手术,减少病人痛苦,简单方便,又不增加费用等优点,是治疗尺骨鹰嘴骨折较理想的方法。     

可吸收张力带在尺骨鹰嘴或内踝骨折中的应用

目的介绍可吸收螺钉和可吸收线组成可吸收张力带固定尺骨鹰嘴或内踝骨折的方法及疗效。方法将尺骨鹰嘴或内踝骨折复位，以1枚可吸收螺钉将尺骨鹰嘴与尺骨干或内踝与胫骨固定，骨干与螺钉尾部以可吸收线作张力带固定。结果可吸收张力带固定尺骨鹰嘴骨折59例，内踝骨折43例，固定牢靠，功能恢复良好。结论可吸收张力带固定尺骨鹰嘴骨折或内踝骨折操作简便，疗效满意，并发症少，无需二次手术取内置物。     

可吸收张力带在骨折中的临床应用

目的探讨可吸收张力带固定的生物力学性能及其在骨折治疗的临床应用效果。方法72例髌骨和20例尺骨鹰嘴骨折采用可吸收张力带治疗。结果患者全部获得随访,骨折得到愈合,未发生骨折断端再移位。结论可吸收张力带在临床应用治疗骨折具有较好的生物力学性能和效果,能避免金属内固定物可能产生的诸多并发症,且无需二次取出。     

改良带尾孔针丝张力带治疗尺骨鹰嘴骨折疗效观察

目的探讨改良带尾孔针丝张力带治疗尺骨鹰嘴骨折的疗效。方法对采用改良带尾孔针丝张力带治疗 33例尺骨鹰嘴骨折的病例作回顾性总结分析。结果 33例均达解剖复位,关节功能恢复达优28例,良5例;无术后感染及固定物松动等不良后果。结论带尾孔针丝张力带治疗尺骨鹰嘴骨折,疗效优良,术后无不良后果。     

可吸收张力带固定尺骨鹰嘴骨折

[目的]介绍可吸收螺钉和可吸收线组成可吸收张力带固定尺骨鹰嘴骨折。[方法]将尺骨鹰嘴骨折复位，以1枚可吸收螺钉将其与尺骨干固定，尺骨干与螺钉尾部以可吸收线作张力带固定。[结果]可吸收张力带固定尺骨鹰嘴骨折59例，固定牢靠，功能恢复良好。[结论]可吸收张力带固定尺骨鹰嘴骨折操作简便，疗效满意，并发症少，无需2次手术取内置物，值得推广。     

经皮克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折

目的评价经皮克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折疗效。方法对本院2005年7月至2009年5月32例尺骨鹰嘴骨折患者采用经皮克氏针钢丝张力带内固定治疗。所有患者均为闭合性骨折,尺骨鹰嘴骨折按Cohon分型：Ⅰ型撕脱型9例,Ⅱ型斜型15例,Ⅲ型8例,对所有患者随访,并对随访患者按Broberg和Morrey评估标准评定。结果手术时间平均为40～60分钟,本组32例全部随访6个月～3年,平均14个月。全部骨性愈合,关节功能恢复良好,无感染、断针、创伤性关节炎等情况。按Broberg和Morrey评估标准,优22,良8例,可2例,差0例,优良率93．8％。结论经皮克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折疗效确切,创伤小,操作简单,并发症少。     

尺骨鹰嘴骨折两种治疗方法的疗效比较

目的：比较尺骨鹰嘴钢板和张力带治疗尺骨鹰嘴骨折的疗效。方法：采用2种方法治疗尺骨鹰嘴骨折63例，张力带内固定组（A组）35例，男21例，女14例；年龄15-62岁，平均48．9岁。尺骨鹰嘴钢板内固定组（B组）28例，男20例，女8例；年龄25～67岁．平均50．6岁。按Delee，JC（1984）分类方法，A组1A型5例，1B型8例，2型14例，3型7例，4型1例；B组1A型3例，1B型5例，2型6例，3型11例，4型3例。比较两组固定方法的疗效。结果：63例患者均获随访，时间6～15个月，参照庞桂根疗效评价标准，B组：优20例，良7例，可1例，差0例；A组：优23例，良10例，可2例，差0例。两种治疗方法疗效差异无统计学意义。结论：尺骨鹰嘴钢板和张力带都是治疗尺骨鹰嘴骨折的有效方法，可根据具体情况选择使用。     

可吸收张力带内固定治疗儿童尺骨鹰嘴骨骺骨折

目的介绍2种可吸收张力带内固定治疗儿童尺骨鹰嘴骨骺骨折,并评价其疗效。方法回顾性分析自2006-01—2013-12应用2种方法治疗42例MorreyⅢ型尺骨鹰嘴骨骺骨折。依据年龄、体重分为2组,采用克氏针联合吸收线治疗27例,采用单纯可吸收线"∞"字结扎治疗15例。结果 2组获得随访(13.21±6.56)个月。2组切口长度、手术时间、出血量、Mayo肘关节功能评分、内固定并发症情况比较,差异无统计学意义(P0.05)。42例的骨折愈合率为97.67%,Mayo评分优良率86.05%。结论儿童尺骨鹰嘴骨骺骨折的诊断存在一定难度,MorreyⅢ型骨折常需手术治疗。2种可吸收张力带法治疗儿童尺骨鹰嘴骨骺骨折均有效,可避免二次住院取内固定,短期疗效满意,可灵活选择。     

肱骨髁上截骨术后可吸收与金属张力带固定治疗肘内翻的研究

目的:比较肱骨髁上楔形截骨术后可吸收张力带(可吸收螺钉或棒和可吸收线)与金属张力带(克氏针和钢丝)固定治疗肘内翻的疗效。方法:采用2种张力带固定肱骨髁上楔形截骨术后骨端治疗33例肘内翻。可吸收张力带固定组15例,其中男12例,女3例;年龄13~24岁,平均16岁;术前内翻角为17°~34°,平均26°。金属张力带固定组18例,其中男15例,女3例;年龄12~22岁,平均14岁;术前内翻角为17°~40°,平均29°。根据术后畸形矫正和关节功能恢复情况评定疗效。结果:本组均获随访,随访时间18~69个月,平均37个月。截骨处平均愈合时间为6周。根据疗效评定标准,可吸收张力带组优13例,良2例,差0例;金属张力带组优15例,良2例,差1例。2种治疗方法临床疗效比较无统计学差异。结论:可吸收张力带是固定肱骨髁上截骨治疗肘内翻的有效方法之一,具有无须Ⅱ期手术取出内固定物的优点,简单方便,降低感染机会。     

Biodegradable wire fixation in olecranon and patella fractures combined with biodegradable screws or plugs and compared with metallic fixation

The outcome of olecranon and patella fractures fixed with biodegradable implants (self-reinforced poly-l-lactide wire combined with self-reinforced polyglycolide screw or self-reinforced poly-l-lactide plug) or with metallic implants (tension band wiring, Kirschner wire and metallic cerclage wire) was compared in a prospective, randomized study. Twenty-five olecranon fractures (15 with biodegradable implants and 10 with metallic ones) and 10 patella fractures (6 with biodegradable implants and 4 with metallic ones) were treated. There were no differences between these methods in outcome. Olecranon and patella fractures can be treated using biodegradable implants successfully. The total expenses are lower because a second operation is not needed to remove the implants after fracture consolidation.     

5种方法治疗髌骨骨折164例

目的:探讨根据髌骨骨折的具体情况采用不同的治疗方法,并对临床结果进行分析。方法:回顾性分析2005年7月至2009年12月收治髌骨骨折164例,男113例,女51例;年龄21～72岁,平均38.5岁。摔伤80例,车祸伤73例,击打伤11例。线性骨折或髌骨分离0.5cm者21例,髌骨分离0.5cm且为单纯横行或纵行骨折者63例,髌骨分离为3块者34例,分离为4块及以上者46例。其中保守治疗21例,钢丝环扎加"8"字内固定术治疗39例,空心钉及张力带钢丝内固定术治疗43例,经皮空心钉内固定术治疗29例,镍钛聚髌器内固定术治疗32例。结果:164例均获随访,时间3～36个月,平均14个月。按Lysholm膝关节评分标准:保守治疗优良19例,钢丝环扎加"8"字内固定优良36例,空心钉及张力带钢丝内固定优良40例,经皮空心钉内固定优良27例,镍钛聚髌器内固定优良30例。结论:能手法整复、固定者,尽量避免手术;需要手术治疗者应根据骨折类型选择不同的术式,可以经皮复位固定的,尽量微创手术;不管保守治疗还是手术内固定,都需要尽早进行合适的功能锻炼。     

The role of cancellous screw with tension band fixation in the treatment of displaced olecranon fractures,a comparative study

Introduction  Fractures of the olecranon are among the most common injuries involving the upper extremity and require operative intervention if displaced. The most commonly used method of fixation for this type of fracture is the AO tension band wiring, although the results of this technique have been generally good, still problems have occurred, including loss of fixation, nonunion, and high re-operation rate for hardware removal. Aim of the study  To compare the results of treatment of displaced fractures of the olecranon using AO tension band wiring versus intramedullary screw with tension band. Materials and methods  In a prospective study, 30 patients with transverse or oblique olecranon fractures, were randomly divided into two equal groups, one group treated using AO tension band wiring the other group using an intramedullary cancellous screw plus tension band. Results  In the screw plus tension band group, 11 (73.3%) patients had excellent results, four (26.7%) had good results and none had fair or poor results, only one(6.6%) patient required second operation for removal of prominent hardware. In the AO tension band group, six (40%) patients had excellent results, five (33.3%) had good, three (20%) had fair and one (6.7%) patient had poor result, and eight patients (53.3%) required second operation for removal of prominent hardware. Conclusion  Using an intramedullary screw combined with tension band in treatment of displaced transverse and oblique olecranon fractures gives better clinical results and has much less re-operation rate for removal of hardware when compared to AO tension band wire fixation, avoiding costs, work time loss and possible complications from hardware removal.     

经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折

目的：探讨经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折的手术方法及疗效。方法：采用经尺骨鹰嘴截骨双钢板内固定治疗肱骨髁间严重粉碎性骨折30例,男19例,女11例;年龄21-62岁,平均42．3岁。按AO／ASIF分类：C2型17例,C3型13例。21例内外侧均采用重建钢板,9例外侧采用重建钢板,内侧采用1／3管形钢板。结果：术后随访6个月-3年,平均1．5年。骨折愈合时间3～6个月,平均4个月。无骨不连、骨化性肌炎、迟发性尺神经受压、内固定失效等并发症。按Aitken—Rorabeck标准评分系统对其肘关节功能评定,优16例,良10例,可2例,差2例。结论：手术解剖复位重建肘关节稳定,术后早期功能锻练,是肘关节功能恢复的重要因素,经尺骨鹰嘴截骨是治疗肱骨髁间严重粉碎性骨折较好入路。     

鹰嘴截骨入路双钢板固定治疗肱骨髁间骨折

目的：探讨尺骨鹰嘴截骨入路应用肱骨内、外髁双钢板治疗肱骨髁间骨折的方法和临床疗效。方法：2001年6月至2007年3月采用尺骨鹰嘴截骨入路结合肱骨内、外髁双钢板治疗肱骨髁间骨折38例,男24例,女14例;年龄19～48岁,平均37岁;全部病例均为闭合性骨折。根据A0肱骨髁间骨折分型：C1型12例,C2型20例,C3型6例。受伤至手术时间6h～14d,平均7d。结果：38例患者均获得随访,时间5个月～2年,平均12个月。1例切口愈合欠佳,经换药治疗后愈合。骨折均已愈合,无骨不连发生,无内固定松动及断裂。愈合时间12-22周,平均15周。根据改良的Cassebaum评价标准评价肘关节功能：优15例,良17例,可5例,差1例。结论：经尺骨鹰嘴截骨入路显露骨折充分,肱骨内、外髁双钢板固定肱骨髁间骨折牢固可靠,早期功能锻炼是提高疗效的关键因素。     

Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided.     

肱三头肌腱尺骨鹰嘴止点断裂的临床特征

目的 ：观察肱三头肌腱尺骨鹰嘴止点断裂的临床特征。方法 ：自2005年6月至2011年11月,共收治肱三头肌腱尺骨鹰嘴止点断裂19例,男7例,年龄15~41岁,平均24.1岁;女12例,年龄16~73岁,平均51.4岁。左侧8例,右侧11例。行走跌伤17例,高处坠落伤2例。单纯肱三头肌腱尺骨鹰嘴止点断裂13例,合并其他肘部损伤6例。合并桡骨头骨折5例,肱骨小头骨折1例,尺骨冠状突骨折1例,肱骨内上髁骨折1例。所有病例在肘关节侧位X线片上显示＂骨片征＂,合并伤有相应表现。均予手术治疗：＂8＂字钢丝固定15例,＂8＂字钢丝加克氏针固定1例,钢丝环扎固定1例,不吸收线缝合2例。合并伤予相应处理。除2例合并伤较重患者术后石膏固定4周,其余病例未行外固定。术后随访采用Mayo肘关节评分评价肘关节功能。结果：19例术后均获随访,1例术后1年死于其他疾病,其余18例随访时间14~91个月,平均47.9个月。Mayo肘关节评分优16例,良2例。结论：肱三头肌腱尺骨鹰嘴止点断裂临床上并不少见,好发于50岁以上女性和30以下男性,手术治疗效果良好,但合并有其他肘部损伤患者常遗留不同程度功能障碍。     

Reconstruction of Mason type-III and type-IV radial head fractures with a new fixation device: 23 patients followed 1–4 years

Background?Treatment options in radial head fractures of Mason types III and IV range from open reduction and internal fixation (ORIF) to radial head resection with or without prosthetic replacement.

Patients?In a prospective study, the radiographic and clinical outcome was evaluated in 23 patients (age median 51 years) with 23 complex radial head fractures median 2 (1–4) years after ORIF using a new fixation device (FFS; Orthofix). 14 Mason type-III fractures with 2 concomitant olecranon fractures and 1 ulnar nerve lesion, and 11 type-IV fractures with 2 olecranon fractures and 2 fractures of the coronoid process were treated. 2 patients were lost to follow-up. In 7 cases of joint instability, an elbow fixator with motion capacity was applied after ORIF of the radial head.

Results?No radial head resection was necessary. No secondary dislocations or nonunion occurred. The Morrey elbow score was excellent in 8 and good in 4 Mason type-III fractures and excellent in 5, good in 3, and fair in 3 Mason type-IV fractures.

Interpretation?Reconstruction of comminuted radial head fractures can be performed with this device and radial head resection can be avoided.